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ALIGARH, India, 3 May 2010 - From hope to despair to lasting hope. This is the true roller-coaster ride of an ASHA (Accredited Social Health Activist) who despite all adversities related to gender, ca
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By Kulsum Mustafa

ALIGARH, India, 3 May 2010 - From hope to despair to lasting hope. This is the true roller-coaster ride of an ASHA (Accredited Social Health Activist) who despite all adversities related to gender, caste and poverty has created history. She is credited with heralding a spree of institutional deliveries in her village. The first child from her village to be born in hospital was in September 2009.
ASHA meaning ‘hope’ in Hindi, is a link between the community and health care delivery system; but for nearly three years after Puja Devi was selected as an ASHA in 2006, she was still not ‘accepted’ by the villagers. After all, Puja hailed from a ‘low’ caste and poor labor family of Binamai village, in Aligarh District of Uttar Pradesh.

Puja describes those humiliating days in her own words, “While my own community members scorned at me, showing no faith in my acquired health skills; the upper caste families, which comprise nearly 55 per cent of the village population, shunned me and called me inauspicious as I hail from a low caste”. Slowly the euphoria about being an ASHA had also started fading away. She became angry and frustrated. She lost her self-confidence and felt like a failure. She wanted to quit, ‘call it a day’. Just then something happened that changed everything.

A group of research students from Aligarh Muslim University’s Sociology and Social Work Department and a Block Supervisor visited the ASHA. They were working on Comprehensive Child Survival Programme (CCSP) Supportive Supervision, a project implemented jointly by Government of Uttar Pradesh and Aligarh Muslim University; supported by UNICEF.
In the words of Dr. Mohd Arif, Supervisor for Atrauli Block, "During our visits to Binamai village, we noticed that Puja’s caste and her low economic stature was coming in the way of her work.

We immediately started counseling sessions with the villagers. We explained to them the role and importance of ASHA. We told them how Puja has received trainings to manage newborns & pregnant women and how she can guide the village women, making use of the skills she has learnt in the trainings – regarding care at birth, breast feeding, keeping child warm, preparations required for institutional delivery as well as its importance, etc. Initially they were wary but slowly they started shedding their negative attitude.”

Mohd Arif encouraged the Medical Officer of the nearby primary health centre, Dr. to visit the village.“The Medical Officer’s interaction with the villagers with Puja by his side, along with the project staff certified Puja’s capability to handle health issues. This helped a great deal to change the mind set of the villagers. She was soon accepted as a representative of health system, trained to provide health services at their door step, hem,” said Project Coordinator, Nadeem Javed

Puja’s perseverance paid and history was created. The village got its first institutional delivery on 15th September 2009. This was followed by two more in the same month. Hemlata and Rakesh became the proud parents of Priyanka - the first child of the village to be born in the hospital. Soon after, Ratan Babu and Baby also had an institutional delivery.

This is no mean achievement, considering the fact that the nearest government hospital is 22 km away and primary health centre, 8. In addition, the only available mode of transport is a horse-cart.
Today Puja is welcome in every house in the village. As she walks through the lanes, her head covered by the veil, women, across the caste barriers, call out to her; she is a friend, a well wisher; a true ASHA.